Comparative study of emphysematous pyelonephritis and pyelonephritis in type 2 diabetes: a single-centre experience

Aerococcus viridans pyelonephritis in a young age female patient with type 1 diabetes mellitus: a rare case report

Background

Aerococcus species are Gram-positive cocci, with negative catalase and oxidase activities and growth characteristics similar to viridans streptococci. They rarely cause infection in humans. However, there are reports of bacteremia, meningitis, septic arthritis, and endocarditis due to this pathogen in the literature. Herein we report a rare case of pyelonephritis due to A. viridans.

Case presentation

A 31-year-old-female patient with type 1 diabetes mellitus was presented with left loin pain, fever, nausea, and anorexia for 3 days. She had a history of obstructive nephropathy due to sloughed necrotic papillae 3 months earlier, mandating bilateral JJ stent insertion. She was treated with a 2 weeks course of doxycycline (100 mg, twice daily) based on the antibiotic susceptibility profile of her urine culture and responded well.

Conclusion

This case highlights the possibility of complicated urinary tracts infection due to a rare human pathogen.

Serratia fonticola and its role as a single pathogen causing emphysematous pyelonephritis in a non-diabetic patient: A case report

BACKGROUND

Diagnosis of emphysematous pyelonephritis has been described around the world for some decades, frequently associated with Escherichia coli and other anaerobic, gas-forming bacteria and mostly in patients living with diabetes. We present a case report of emphysematous pyelonephritis in a non-diabetic patient caused by Serratia fonticola as well as a brief literature review to draw attention to this rare pathogen as a cause of pyelonephritis.

CASE SUMMARY

A 38-year-old female presented with fever, severe pain in the right flank and changes in urinary habits. She was admitted, and emphysematous pyelonephritis was confirmed by an abdominal computerized tomography and urine cultures; the latter showed Serratia fonticola as a single pathogen. After 3 d of being treated with piperacillin/tazobactam and percutaneous drainage she became afebrile, and the gas presence reduced.

CONCLUSION

Emphysematous pyelonephritis infections in non-diabetic patients are rare but can be severe and life-threatening. This case suggests that Serratia fonticola infection can occur in patients undergoing invasive or instrumented procedures.